Slaunwhite D, Tuggey R L, Reynoso G
Ann Clin Lab Sci. 1978 Mar-Apr;8(2):117-21.
Fractionation of serum alkaline phosphatase by either biochemical or electrophoretic techniques is often insufficient to determine the source of the elevated serum enzyme. In 31 unselected patients with high serum alkaline phosphatase a simultaneous determination of serum gamma glutamyl transpeptidase and urinary hydroxyproline excretion rates was performed, in addition to urea denaturation and L-phenylalanine inhibition tests. Of 25 patients with definite diagnosis, the urea denaturation test correctly identified the source of the elevated serum alkaline phosphatase (ALP) in 16 (64 percent). The serum gamma-glutamyl transpeptidase (GGTP) alone predicted the correct diagnosis in 64 percent of the cases and the urinary hydroxyproline (HOP) alone in 69 percent. When all three tests were performed simultaneously, the combination of results identified the source of the ALP in 88 percent of the cases. It is believed that this combination offers better sensitivity and specificity than any of the three tests used individually.
采用生化或电泳技术对血清碱性磷酸酶进行分级分离，往往不足以确定血清酶升高的来源。在31例未经挑选的血清碱性磷酸酶水平较高的患者中，除了进行尿素变性和L-苯丙氨酸抑制试验外，还同时测定了血清γ-谷氨酰转肽酶和尿羟脯氨酸排泄率。在25例确诊患者中，尿素变性试验正确识别出16例（64%）血清碱性磷酸酶（ALP）升高的来源。仅血清γ-谷氨酰转肽酶（GGTP）在64%的病例中预测出正确诊断，仅尿羟脯氨酸（HOP）在69%的病例中预测出正确诊断。当同时进行这三项试验时，结果组合在88%的病例中识别出了ALP的来源。据信，这种组合比单独使用的三项试验中的任何一项都具有更高的敏感性和特异性。
